HMG‐CoA Reductase Inhibitors and the Risk of Vertebral Fracture (original) (raw)
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Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
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Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
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Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
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Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
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Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
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Drug Safety Unit, Inspectorate for Health Care, The Hague, The Netherlands
Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
Address reprint requests to: Bruno HCh Stricker, PhD, Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 1738, Rotterdam 3000 DR, The Netherlands
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Received:
24 February 2004
Revision received:
19 April 2004
Published:
02 December 2009
Cite
Mariette WCJ Schoofs, Miriam CJM Sturkenboom, Marjolein van der Klift, Albert Hofman, Huibert AP Pols, Bruno HCh Stricker, HMG‐CoA Reductase Inhibitors and the Risk of Vertebral Fracture, Journal of Bone and Mineral Research, Volume 19, Issue 9, 1 September 2004, Pages 1525–1530, https://doi.org/10.1359/JBMR.040607
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Abstract
Statins inhibit an enzyme in the mevalonate pathway and therefore may affect bone. In this first study on both symptomatic and nonsymptomatic vertebral fractures in the elderly (N = 3469), we show that long‐term statin use is significantly associated with a 50% lower vertebral fracture risk. Randomized trials on statins and fractures, carried out in populations at risk for fractures, are needed.
Introduction: Statins are cholesterol‐lowering agents that could potentially affect bone. Previous studies on statin use and fracture risk reported contradictory results and did not include both symptomatic and nonsymptomatic vertebral fractures.
Materials and Methods: To examine the association between statin use, vertebral fractures, and lumbar spine BMD, we performed a prospective population‐based cohort study in men and women (N = 3469) ≥55 years of age. These individuals had both baseline and follow‐up spinal X‐rays available. Statin use was obtained from detailed computerized pharmacy data, and the total number of days of exposure before second X‐ray was calculated. A multivariate logistic regression model was fitted to calculate odds ratios and CIs.
Results: During a mean follow‐up of 6.5 years, 176 incident vertebral fractures occurred. There were 508 statin users and 16 exposed cases. The adjusted relative risk for incident vertebral fracture in users of statins (compared with nonusers) was 0.58 (95% CI, 0.34‐0.99). The relative risk decreased on higher cumulative use to 0.52 (95% CI, 0.28‐0.97) for use for more than 365 days during the study period. Use of (the hydrophilic statin) pravastatin and use of nonstatin cholesterol‐lowering drugs was not significantly associated with vertebral fracture risk. Statin use was not significantly associated with lumbar spine BMD.
Conclusion: Statin use is associated with a lower risk of vertebral fracture. Randomized clinical trials in a population at risk for fracture are needed to examine this association.
Copyright © 2004 ASBMR
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